Bulimia Nervosa

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

While there is no known specific cause for bulimia, family history and environmental stressors are thought to contribute to the development of the illness.

Adolescents are most at risk for developing bulimia, as statistics show that about three-quarters of people who develop the illness do so before they reach 22 years of age, most often at 15 to 16 years of age.

Cognitive behavioral therapy is thought to be somewhat superior to other forms of psychotherapy in treating this eating disorder.

Medication, nutritional counseling, and family therapy are also often part of the treatment for bulimia.

The potential complications of bulimia can be severe and affect virtually every organ system.

Only about 45% of people with bulimia fully recover, but recovery is more likely with treatment.

What is bulimia?

Bulimia, also called bulimia nervosa, is one of a number of eating disorders. This mental illness is characterized by episodes of bingeing and somehow purging the food and/or associated calories in the pursuit of weight loss. About 1%-2% of adolescent girls in the United States develop bulimia. While bulimia and other eating disorders tend to occur most often in Caucasian females in this country, males and ethnic minorities are increasingly developing eating disorders. Bulimia is also often co-morbid (co-occurs with) body dysmorphic disorder, which involves the sufferer having a false sense that something is defective with their appearance beyond weight.

Women with eating disorders tend to have higher rates of infertility than women without an eating disorder, in that eating disordered women have lower rates of pregnancy and childbirth. When pregnancy is achieved, more than 7% of women suffer from some form of eating disorder during that time, with more than 2% engaging in both bingeing and some form of purging behaviors. Given the changes in body chemistry that such behaviors can cause, bulimia during pregnancy can pose significant health risks for the developing fetus.

This illness is a significant public-health problem both because of the physical and mental-health effects it can have. Bulimia often co-occurs with depression, anxiety, and substance-abuse disorders and results in a loss of productivity due to disability that is higher than that of disability caused by depression and anxiety combined.

Drunkorexia, Manorexia, Diabulimia: New Eating Disorders?

In recent weeks, I have read media reports that mentioned both "drunkorexia"
and "manorexia." I have fielded questions about "diabulimia" from coworkers and
friends. From the sound of these terms, it appears that there are a lot of new
and recently discovered eating disorders.